Leung M, et al. - Researchers assessed the link between left atrial (LA) reservoir strain and total atrial conduction time (PA-TDI), which are indicators of LA fibrotic content. Study participants were patients (mean age 56 years, 53% male) with a first episode of atrial fibrillation (AF) and controls (mean age 64 years, 71% male) with no structural heart disease who underwent echocardiography. Comparisons between LA volumes, PA-TDI, LA reservoir strain, and left ventricular (LV) global longitudinal strain (GLS) were carried out. They found that, regardless of the presence or burden of AF, a negative correlation between PA-TDI and LA reservoir strain was shown by all subjects. Relative to paroxysmal AF (PAF) and controls, longer PA-TDI and impaired LA reservoir strain were detected in patients with persistent AF. This implied increasing burden of fibrosis and LA structural remodeling in the progression of AF.